Oct201414

The HSE said all private day case inpatient services “are to be charged for whether provided on a bed or on equipment other than a bed such as a therapy chair, recliner or trolley”

Martin Wall

Tue, Oct 14, 2014, 01:00

Public hospitals have been told by the Department of Health that they must levy official charges of between €300 and €400 a day on private patients even if they are treated on a trolley or in a therapy chair.

In a memo to hospital managers in recent days the Health Service Executive said it had been advised by the Department of Health that, under legislation, a charge must be made for all inpatient services.

While it is not specifically stated in the memo, the department said last night that the charges would not apply to patients on trolleys in emergency departments but would apply to those who were on trolleys in other parts of a hospital.

The department told the HSE, following advice from the Attorney General, that it was not material to the charge what bed, chair or other piece of equipment or ward was used by the private patient in a public hospital.

Refusal to pay

The HSE memo said some insurers had been refusing to pay for subscribers treated as day cases in public hospitals unless they were treated in a bed.
The HSE said the Department of Health had made clear that all private day case inpatient services “are to be charged for whether provided on a bed or on equipment other than a bed such as a therapy chair, recliner or trolley”.

Hospital chief executives were told that the department had made clear they had to charge all private patients for all inpatient services regardless of whether the admission was an emergency or on an elective basis, whether they were admitted to a designated private bed or beds in intensive care or coronary care units, whether they were treated in a ward or elsewhere and whether they were treated on a bed or on other equipment such as a therapy chair, recliner or trolley.

The memo indicated that where hospitals had not been levying such charges, they should do so now, backdated to the beginning of the year.

Under legislation that came into force in January, hospitals were permitted to charge for all private patients admitted to public hospitals. Previously, insurers paid only for subscribers who occupied the 20 per cent of beds that were designated for fee-paying patients.

Not charged

The Comptroller and Auditor General estimated in 2010 that 45 per cent of private inpatients were not charged for maintenance because they were not in designated beds.
The department said the legislation enabled public hospitals to charge all private inpatients in public hospitals. “It does not relate to private outpatient services in public hospitals and does not relate to emergency departments, where a charge of €100 applies, subject to certain exemptions.”

The department said “best clinical practice for chemotherapy or dialysis patients is to treat them in a seated or reclining position”. It said trolleys were routinely used in day surgery procedures such as colonoscopy.Meanwhile the Government is not expected to not toincrease the existing prescribption ingcharge rateof €2.50 per item or raise the hospital in-patient or emergency department charges in the Budget today. There is also expected to be no change to the current thresholds for medical card eligibility.